Falling Back To Win Votes

President's Retreat On Public Option Boosts Odds Of Health Reform

Analysis

WASHINGTON - -By dropping his insistence on a public health insurance option, President Barack Obama angered some liberals but he took a big step toward winning swing votes among moderate Democrats - a trade-off that sharply improved the odds on eventual passage of a far-reaching overhaul of the nation's health care system.

For most Americans, Obama's tactical retreat increased the likelihood that other key provisions of the evolving legislation might become law. Among them: barring insurance companies from denying coverage of pre-existing conditions or cutting off benefits when policyholders become ill, and features to make it easier for small businesses to cover workers.

Even as it pulled back, the White House expressed Obama's new position in calibrated language. It left open the possibility that he would support a bill that included a government-run plan but made clear that the absence of a public option was not a deal killer. Many congressional analysts expect the House to approve some form of public plan and the Senate to reject it, setting up a showdown in the final round of negotiations.

"The president has always made it clear that what's important are the goals. And he thinks that a public option is a good way to get to those goals," said Linda Douglass, a spokeswoman for the administration's health care proposal.

The political gain for Obama on Capitol Hill was clear in the reaction Monday of Rep. Rick Boucher, a Virginia Democrat who voted against the bill when it came before the House Energy and Commerce Committee. Boucher said Obama's willingness to back away from the public option strengthened his hand among conservative Democrats and other skeptics without compromising the basic goal of lowering health care costs and insuring more people.

Dropping that option from the bill, Boucher said, "creates the opportunity to pass the health care bill. As long as there was insistence on a government-operated plan, that opportunity did not exist."

"A government-operated health care plan is not essential to an effective health care reform," he said. Boucher was one of five Democrats who opposed the bill when it cleared the committee in July.

In an interview Monday, a senior Obama administration official described a government-run plan as merely a "means to an end."

In addition to placating moderate "Blue Dog" Democrats, Obama sought to blunt what was turning into one of his opponents' most emotion-charged lines of attack, namely the charge that the president sought to give government a bigger, more intrusive role in the medical affairs of individuals.

Resistance to creating a government option has also stiffened in recent weeks among powerful interest groups, including insurers and business lobbyists.

Centrist Democrats welcome the new White House flexibility.

Rep. Jason Altmire, a Pennsylvania Democrat and a second-term member from a swing district, said, "It's going to bring votes of centrist Democrats." Altmire, one of three Democrats to vote against the bill in the House Education and Labor Committee, said the government plan has "become a flash point."

Ron Pollack, president of Families USA and a leading consumer advocate who has been pushing for a health system overhaul for decades, said his group has been distributing a memo to its nationwide network of activists promoting the "10 Reasons to Support the Health Care Reform Bills." The government plan option is only one of them.

"The health reform bills have many critical factors designed to make health care more accessible and more affordable," Pollack said in an interview.

Pollack and others note that the bills working their way through the House and Senate include provisions that would transform the way Americans get health insurance - even without a new government plan.

"The public plan is not the essential element of reform," said Jim Kessler, vice president for policy at Third Way, a centrist Democratic think tank in Washington that has been advising Democrats to shift away from demanding a new government plan.

When it comes to strategy, many lawmakers have long seen such a concession as essential to getting any health care bill through the Senate, where 60 votes are needed to ensure passage.

All 40 Senate Republicans oppose the public option, as do some Democrats, including Senate Budget Committee Chairman Kent Conrad of North Dakota.

Senate Majority Leader Harry Reid of Nevada has been working to overcome political obstacles in the Senate, where a small, bipartisan group of lawmakers has been trying to reach a compromise.

Obama's willingness to jettison the public option risks alienating some in his liberal base, though. Jed Lewison, a progressive blogger, said that were a health care bill to pass without a government-run program, grass roots support for future Obama objectives may be more tepid.

"People's intensity will definitely diminish," Lewison said. "People have been listening to strong arguments for the public option coming from the administration. And they believe those arguments. If it comes down to where people feel like in the last few yards of the field the rug was pulled out from underneath them, they may not be as willing to work hard the next time around."